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NPI Code Detail

MEDICARE: JENNIFER MUIR CO, LO

MEDICARE: JENNIFER MUIR CO, LO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1222Z00000XOrthotist

General Provider Information

NPI Number : 1811294598
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER MUIR CO, LO
Provider Business Mailing Address
First Line : 723 MARTIN LUTHER KING JR WAY
Second Line :
City : TACOMA
State : WA
Zip : 98405-4139
Country : US
Telephone Number : 253-572-7478
Fax Number : 253-593-7980
Provider Business Practice Location Address
First Line : 723 MARTIN LUTHER KING JR WAY
Second Line :
City : TACOMA
State : WA
Zip : 98405-4139
Country : US
Telephone Number : 253-572-7478
Fax Number : 253-593-7980
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2011
Last Update Date : 11/18/2011

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Directions to “ JENNIFER MUIR CO, LO” Practice Location

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